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Medicare and Your Retirement: Coordinating Coverage Correctly

Understanding Medicare Coverage in Retirement: Why Coordination Matters

Transitioning into retirement brings many changes, and understanding how to coordinate your Medicare coverage correctly ranks among the most crucial financial and health decisions you’ll make. At PromiseCare Medical Group, our 60+ primary care physicians and 400+ medical specialists serving Riverside County understand that navigating Medicare’s complexities can feel overwhelming—especially when you’re trying to align multiple coverage sources while avoiding costly mistakes.

Medicare coordination becomes particularly important when you have additional insurance coverage beyond Original Medicare. Whether you’re managing employer-sponsored retiree insurance, considering a Medicare Advantage Plan, or wondering how your current coverage transitions as you retire, proper coordination ensures you maximize your benefits while minimizing out-of-pocket costs.

The stakes are significant. According to Fidelity’s 2025 retirement healthcare cost estimates, a 65-year-old retiring in 2025 can expect to spend an average of $172,500 on health care and medical expenses throughout retirement—a 4% increase from the previous year. Understanding how to coordinate your coverage correctly can help you manage these substantial costs more effectively.

This comprehensive guide explains everything you need to know about coordinating Medicare coverage in retirement, including how different Medicare parts work together, how to align Medicare with other insurance, and how PromiseCare Medical Group’s network supports Medicare beneficiaries throughout Riverside County.

The Four Parts of Medicare: Building Your Coverage Foundation

Medicare Part A: Hospital Insurance

Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. Most people qualify for premium-free Part A because they or their spouse paid Medicare taxes for at least 40 quarters (10 years) during their working years.

What Part A Covers:

Part A Cost-Sharing for 2026:

Medicare Part B: Medical Insurance

Medicare Part B covers doctor visits, outpatient care, preventive services, medical equipment, and other healthcare services not covered by Part A. Unlike Part A, Part B requires a monthly premium that most beneficiaries pay.

What Part B Covers:

Part B Costs for 2026:

At PromiseCare Medical Group, all our physicians accept Medicare Part B, ensuring you can access quality primary care and specialist services throughout our network of 60+ primary care physicians and 400+ specialists.

Medicare Part C: Medicare Advantage Plans

Medicare Advantage Plans (also called Medicare Part C) are offered by private insurance companies approved by Medicare. These plans must cover everything Original Medicare covers (Parts A and B) and often include additional benefits.

Medicare Advantage Plan Benefits:

PromiseCare Medical Group and Medicare Advantage:
PromiseCare Medical Group is in-network with many Medicare Advantage Plans, including plans from:

Our extensive network ensures Medicare Advantage members can access coordinated, comprehensive care through their preferred PromiseCare provider.

Medicare Part D: Prescription Drug Coverage

Medicare Part D provides prescription drug coverage through private insurance companies. You can get Part D coverage either as a standalone plan (with Original Medicare) or as part of a Medicare Advantage Plan that includes drug coverage.

Part D Coverage Details:

Important: Starting in 2026, beneficiaries automatically get catastrophic coverage after reaching the $2,100 out-of-pocket maximum, meaning no additional costs for covered drugs for the rest of the year.

Understanding Coordination of Benefits: Who Pays First?

Coordination of benefits (COB) determines which insurance plan pays first when you have multiple types of coverage. Understanding this payment hierarchy prevents billing issues and ensures you’re not paying more than necessary.

Primary vs. Secondary Payers

Primary Payer: The insurance that pays first, up to the limits of its coverage. The primary payer processes the claim according to its coverage rules and benefit limits.

Secondary Payer: The insurance that pays second, covering eligible remaining costs after the primary payer has processed the claim. The secondary payer may cover copayments, coinsurance, or deductibles left after the primary payer’s payment.

Medicare Secondary Payer (MSP) Rules

Medicare Secondary Payer rules determine when Medicare pays first versus when it pays second. These federal regulations help protect both your finances and Medicare’s resources from duplicate payments.

When Medicare Pays SECOND:

  1. Active Employment with Group Health Plan: If you or your spouse are actively working with employer coverage from a company with 20+ employees
  2. Retiree Insurance: When your employer-sponsored retiree insurance is primary
  3. Workers’ Compensation: For work-related injuries or illnesses
  4. Liability Insurance: For injuries covered by liability insurance (auto accidents, slip-and-fall incidents)
  5. Federal Employees Health Benefits (FEHB): FEHB typically pays first for federal retirees

When Medicare Pays FIRST:

  1. Employer with Fewer Than 20 Employees: Small employer coverage becomes secondary
  2. COBRA Coverage: COBRA is not considered “current employment” coverage
  3. Retiree Coverage: Once you retire and your employer coverage ends (in most cases)
  4. No Other Coverage: When you have only Medicare

The “20-Employee Rule” Explained

The 20-employee threshold significantly impacts whether you must enroll in Medicare at age 65 or can safely delay.

Working for Large Employer (20+ employees):

Working for Small Employer (fewer than 20 employees):

Coordinating Medicare with Retiree Insurance

Retiree insurance coordination varies based on your specific plan design. In most cases:

  1. Medicare Becomes Primary: Once you enroll in Medicare, it pays first for covered services
  2. Retiree Plan Pays Secondary: Your retiree insurance covers remaining eligible costs (copayments, coinsurance, deductibles)
  3. Gap Coverage: Retiree plans often cover services Medicare doesn’t (dental, vision, hearing, international travel)
  4. Prescription Drugs: Retiree drug coverage may coordinate differently—sometimes as primary, sometimes as secondary to Part D

Important Consideration: Some employers require Medicare enrollment to maintain retiree health benefits. Check with your benefits administrator before making enrollment decisions.

Critical Medicare Enrollment Periods: Timing Matters

Understanding Medicare’s enrollment periods helps you avoid costly late enrollment penalties and coverage gaps.

Initial Enrollment Period (IEP)

Your Initial Enrollment Period is a 7-month window surrounding your 65th birthday:

Example: If your birthday is July 15, your IEP runs from April 1 through October 31.

Coverage Start Dates:

Annual Enrollment Period (AEP)

The Annual Enrollment Period runs October 15 through December 7 each year. During AEP, you can:

PromiseCare Medical Group hosts educational workshops during the Annual Enrollment Period to help Medicare beneficiaries understand their options and make informed decisions about their coverage for the coming year.

Special Enrollment Period (SEP)

Special Enrollment Periods allow penalty-free enrollment outside normal periods due to qualifying life events:

Common SEP Triggers:

Critical: The 8-month SEP after losing employer coverage is your safety net for avoiding late enrollment penalties when transitioning from workplace insurance to Medicare.

General Enrollment Period (GEP)

If you miss your Initial Enrollment Period and don’t qualify for a Special Enrollment Period, you can enroll during the General Enrollment Period (January 1-March 31 each year). However:

Understanding and Avoiding Late Enrollment Penalties

Late enrollment penalties can significantly increase your lifetime Medicare costs. Understanding how they work helps you avoid these permanent premium increases.

Part A Late Enrollment Penalty

If you don’t qualify for premium-free Part A and delay enrollment:

Note: Most people qualify for premium-free Part A and won’t face this penalty.

Part B Late Enrollment Penalty

The Part B penalty is typically the most significant concern for retirees:

Penalty Calculation:

2026 Example:

How to Avoid:

Part D Late Enrollment Penalty

Part D penalties apply if you go 63 or more consecutive days without creditable prescription drug coverage:

Penalty Calculation:

2026 Example:

Creditable Coverage:
Drug coverage is considered creditable if it’s expected to pay as much as Medicare’s standard prescription drug coverage. Common sources:

Important: Your employer must notify you annually whether your prescription drug coverage is creditable. Keep these notices—you’ll need them if you later enroll in Part D.

Medicare Advantage vs. Original Medicare Plus Medigap

Choosing between Medicare Advantage and Original Medicare with a Medigap supplement plan is one of retirement’s most significant coverage decisions.

Medicare Advantage Plans: Comprehensive Bundled Coverage

Advantages:

Considerations:

PromiseCare Medical Group and Medicare Advantage:
PromiseCare is in-network with numerous Medicare Advantage plans, offering:

Original Medicare Plus Medigap: Maximum Flexibility

Advantages:

Considerations:

Key Differences in Coverage Coordination

Feature Medicare Advantage Original Medicare + Medigap
Provider Network Limited to plan network Any Medicare provider
Referrals May be required Not required
Coverage Area Plan service area only Nationwide
Prescription Drugs Usually included Separate Part D plan needed
Out-of-Pocket Maximum Yes ($9,250 in 2026) None (Medigap covers most costs)
Extra Benefits Often included Must purchase separately
Monthly Costs Lower premiums Higher total premiums
Coverage Stability Changes annually Stable

Making Your Decision

Consider these factors when choosing:

Choose Medicare Advantage if you:

Choose Original Medicare + Medigap if you:

PromiseCare Tip: Schedule a consultation with your PromiseCare physician to discuss your health needs, medications, and lifestyle. Our doctors can help you evaluate which coverage approach best supports your individual health management goals.

Special Considerations for Health Savings Accounts (HSAs)

If you’ve been contributing to a Health Savings Account (HSA) while working, understanding how Medicare affects your HSA is crucial.

HSA Contribution Rules with Medicare

Critical Rule: You cannot contribute to an HSA once enrolled in any part of Medicare, including premium-free Part A.

Six-Month Lookback Rule:
When you enroll in Medicare after age 65, your Part A coverage is backdated up to six months (but not before the month you turned 65). This means:

Example:

Using HSA Funds in Retirement

Good News: While you can’t contribute once enrolled in Medicare, you can still use HSA funds tax-free for qualified medical expenses, including:

Medicare-Related Qualified Expenses:

Non-Qualified Expenses (if HSA is used):

HSA Triple Tax Advantage in Retirement:

  1. Tax-free withdrawals for Medicare premiums and medical costs
  2. No Required Minimum Distributions (unlike IRAs)
  3. Can reimburse yourself for past medical expenses (with receipts)

Strategy: If you’ve saved HSA receipts for unreimbursed medical expenses from previous years, you can reimburse yourself at any time, even decades later. This provides tax-free access to HSA funds for non-medical purposes (essentially converting it to an extra retirement account).

Coordinating HSA with Employer Coverage

If you’re delaying Medicare while working past 65:

Coordinating Medicare with Federal Employees Health Benefits (FEHB)

Federal employees and retirees have unique considerations when coordinating Medicare with FEHB coverage.

FEHB Coordination Rules

Key Difference: Unlike most employer coverage, FEHB coverage does NOT require Medicare enrollment to remain active. This gives federal retirees significant flexibility.

Your Options:

  1. Keep FEHB only (don’t enroll in Medicare)
  2. Enroll in Medicare Parts A and B (FEHB becomes secondary)
  3. Enroll in Part A only (FEHB remains primary for most services)

When Medicare and FEHB Work Together

If you enroll in both Medicare and FEHB:

Postal Service Health Benefits (PSHB) Program

Important Change for Postal Employees:
Under the new Postal Service Health Benefits program effective January 1, 2026:

FEHB Coverage After Age 65

Benefits of Adding Medicare to FEHB:

Reasons to Keep FEHB Only:

PromiseCare Guidance: Our care coordination team works with federal retirees to ensure seamless service regardless of your coverage combination. We accept both Medicare and many FEHB plans, making coordination straightforward.

Dual Eligible Special Needs Plans (D-SNPs)

Individuals eligible for both Medicare and Medicaid have specialized plan options designed to coordinate both programs efficiently.

What Are D-SNPs?

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage Plans specifically designed for people who qualify for both Medicare and full Medicaid benefits.

D-SNP Benefits:

Eligibility Requirements

To qualify for a D-SNP, you must:

Enhanced Integrated D-SNP Models

Starting in 2026, many plans are transitioning to enhanced integrated D-SNP models that provide even better coordination:

Special Supplemental Benefits for the Chronically Ill (SSBCI)

Many D-SNPs and other Medicare Advantage plans offer Special Supplemental Benefits for the Chronically Ill (SSBCI) for members with qualifying chronic conditions.

Qualifying Conditions Include:

SSBCI May Include:

Important: Eligibility for SSBCI benefits requires meeting specific clinical criteria demonstrating high risk for hospitalization and need for intensive care coordination.

PromiseCare Medical Group: Supporting Medicare Coordination

At PromiseCare Medical Group, we understand that successful Medicare coordination requires more than just understanding the rules—it requires accessible, coordinated healthcare services that work with your coverage.

Our Medicare-Friendly Network

Extensive Provider Network:

Medicare Acceptance:

Care Coordination Services

For Medicare Beneficiaries, PromiseCare Offers:

Comprehensive Annual Wellness Visits:

Chronic Disease Management:

Case Management Support:

Prescription Drug Management:

Educational Resources

PromiseCare Medical Group provides educational support through:

Annual Medicare Workshops:
During the Annual Enrollment Period (October 15 – December 7), PromiseCare hosts free educational workshops covering:

One-on-One Member Services:
Our Member Services team (951-390-2840) provides personalized assistance with:

Common Medicare Coordination Mistakes to Avoid

Understanding common pitfalls helps you navigate Medicare coordination successfully.

Mistake #1: Missing Enrollment Deadlines

The Problem: Missing your Initial Enrollment Period or Special Enrollment Period leads to:

The Solution:

Mistake #2: Assuming Employer Coverage Is Always Better

The Problem: Small employer coverage (fewer than 20 employees) becomes secondary to Medicare at age 65, potentially leaving you with massive out-of-pocket costs.

The Solution:

Mistake #3: Not Updating Coverage Information

The Problem: Providers don’t know which insurance to bill first, leading to:

The Solution:

Mistake #4: Dropping Employer Coverage Too Early

The Problem: Dropping employer coverage before Medicare starts creates a gap:

The Solution:

Mistake #5: Ignoring Creditable Coverage Notices

The Problem: Not understanding whether your coverage is creditable for Part D purposes can result in:

The Solution:

Mistake #6: Contributing to HSA After Medicare Enrollment

The Problem: Contributing to an HSA after enrolling in any part of Medicare (including backdated Part A) creates:

The Solution:

Mistake #7: Not Reviewing Coverage Annually

The Problem: Medicare Advantage and Part D plans change every year:

The Solution:

Medicare Coordination Checklist: Action Steps for Success

Three Months Before Age 65

□ Determine if you’re automatically enrolled in Medicare (receiving Social Security)
□ Review current employer or retiree coverage
□ Verify employer size (20+ employees or fewer than 20)
□ Contact HR to understand how coverage coordinates with Medicare
□ Request creditable coverage letters for prescription drugs
□ Stop HSA contributions if enrolling in Medicare
□ Research Medicare Advantage plans in your area (including PromiseCare network plans)
□ Compare Medigap plans if choosing Original Medicare
□ Attend Medicare educational workshops (PromiseCare offers these)

During Your Birthday Month

□ Enroll in Medicare Parts A and B (if not automatically enrolled and not delaying)
□ Select Medicare Advantage Plan OR Medigap plan
□ Choose Part D prescription drug plan (if using Original Medicare)
□ Verify your doctors are in your selected plan’s network
□ Confirm prescription drugs are covered under chosen plan
□ Update insurance information with all healthcare providers

After Medicare Starts

□ Verify Medicare card received
□ Confirm effective dates for all coverage
□ Update insurance information at all provider offices
□ Notify current insurance of Medicare enrollment
□ Set up online accounts (Medicare.gov and plan websites)
□ Schedule no-cost annual wellness visit with PromiseCare physician
□ Review Explanation of Benefits statements for accuracy
□ Save all Medicare and plan communications

Annually During AEP (October 15 – December 7)

□ Review Annual Notice of Change (ANOC) from current plan
□ Attend PromiseCare Medicare workshops
□ Verify current doctors remain in network
□ Check prescription drug formulary for changes
□ Compare other available plans using Medicare Plan Finder
□ Evaluate if current plan still meets health needs
□ Consider switching if better option available
□ Make changes before December 7 deadline

Frequently Asked Questions About Medicare Coordination

Can I have both Medicare and employer insurance?

Yes, you can have both Medicare and employer insurance. The coordination depends on your employment status and employer size. If you or your spouse are actively working with coverage from an employer with 20+ employees, the employer plan typically pays first. Medicare becomes primary when you retire, if your employer has fewer than 20 employees, or if you’re on COBRA.

What happens if I don’t enroll in Medicare at 65?

If you don’t enroll at 65 without qualifying for a Special Enrollment Period, you may face permanent late enrollment penalties and coverage gaps. For Part B, the penalty is 10% of the premium for each full year you could have enrolled but didn’t, and this penalty lasts as long as you have Part B coverage. Part D has similar permanent penalties for going 63+ days without creditable drug coverage.

Does Medicare cover services outside the United States?

Original Medicare generally does not cover healthcare services outside the United States, except in limited emergency situations in Canada and Mexico. Some Medicare Advantage plans offer foreign travel emergency coverage, but this is limited. If you travel internationally frequently, consider a Medigap plan that includes foreign travel emergency coverage or purchase travel health insurance separately.

Can I switch from Medicare Advantage back to Original Medicare?

Yes, you can switch from Medicare Advantage back to Original Medicare during the Annual Enrollment Period (October 15 – December 7) or Medicare Advantage Open Enrollment Period (January 1 – March 31). However, getting a Medigap plan after your Initial Enrollment Period may be difficult, as insurance companies can use medical underwriting and deny coverage or charge higher premiums based on health conditions.

How does PromiseCare coordinate care for Medicare patients?

PromiseCare Medical Group coordinates care for Medicare patients through our integrated network of 60+ primary care physicians and 400+ specialists. Our care coordination includes managing specialist referrals, hospital discharge planning, medication management, chronic disease monitoring, and ensuring seamless communication between all your healthcare providers. Our Member Services team also assists with coverage questions and plan selection guidance.

What if I move to a different state after enrolling in Medicare?

Original Medicare (Parts A and B) work anywhere in the United States, so moving doesn’t affect this coverage. However, Medicare Advantage and Part D plans are regional, so moving out of your plan’s service area triggers a Special Enrollment Period. You’ll need to enroll in a new plan available in your new location within 30 days of moving. Notify your plan immediately when you move to ensure continuous coverage.

Can I keep my retiree insurance after enrolling in Medicare?

This depends on your employer’s policies. Some employers require Medicare enrollment to keep retiree benefits, while others allow you to keep retiree coverage with or without enrolling in Medicare. Medicare will typically become the primary payer once you enroll, with retiree insurance paying secondary. Check with your benefits administrator to understand your specific situation and avoid accidentally losing retiree coverage.

How do I know which insurance to show at the doctor’s office?

Always provide all insurance information to your healthcare providers and let them determine which insurance should be billed first. If you have Medicare and another form of coverage, tell the provider about both. The provider’s billing department will determine the correct order based on coordination of benefits rules. At PromiseCare Medical Group, our staff will help ensure we have all your insurance information and coordinate billing correctly.

What is the difference between Medicare Supplement and Medicare Advantage?

Medicare Supplement (Medigap) works with Original Medicare to cover cost-sharing expenses (deductibles, copayments, coinsurance), while Medicare Advantage replaces Original Medicare entirely with a private plan that includes all Part A and B benefits plus usually Part D. Medigap offers provider flexibility (any Medicare doctor) but requires separate Part D enrollment and typically higher monthly costs. Medicare Advantage limits you to network providers but often includes extra benefits and lower premiums.

Does Medicare cover dental, vision, and hearing?

Original Medicare does not cover routine dental care, eye exams for glasses, or hearing aids. However, many Medicare Advantage plans include these benefits. Some Medigap plans do not cover these services either, though you can purchase separate standalone dental and vision insurance. PromiseCare can guide you toward Medicare Advantage plans in our network that include comprehensive dental, vision, and hearing benefits.

Conclusion: Taking Control of Your Medicare Coordination

Successfully coordinating Medicare coverage in retirement requires understanding complex rules, making timely decisions, and staying informed about your options. The coordination challenges may seem daunting, but with proper planning and the right healthcare partners, you can navigate Medicare confidently while maximizing your benefits and minimizing costs.

Key takeaways for successful Medicare coordination:

Start Early: Begin researching Medicare options at least three months before turning 65. Understanding your choices, enrollment periods, and how your current coverage coordinates with Medicare gives you time to make informed decisions without rushed timelines.

Understand Coordination of Benefits: Know whether Medicare will be your primary or secondary payer based on your employment status, employer size, and other coverage. This determines your enrollment timing and helps you avoid costly penalties and coverage gaps.

Avoid Late Enrollment Penalties: These permanent premium increases can add thousands of dollars to your lifetime Medicare costs. Enroll during your Initial Enrollment Period unless you qualify for penalty-free delayed enrollment through a Special Enrollment Period.

Review Coverage Annually: Medicare Advantage and Part D plans change every year. What worked well this year may not be the best option next year. Attend educational workshops, compare plans during the Annual Enrollment Period, and adjust your coverage as your health needs change.

Coordinate with Your Healthcare Providers: Keep your doctors informed about your coverage changes, verify they accept your insurance, and ensure they have current information to avoid billing issues. At PromiseCare Medical Group, our team actively helps coordinate coverage questions and ensures smooth claim processing.

Partner with PromiseCare Medical Group

As Riverside County’s longest continually serving and largest Independent Physician Association network, PromiseCare Medical Group understands the unique healthcare needs of Medicare beneficiaries. Our network of 60+ primary care physicians, 400+ specialists, and 18 urgent care centers provides the comprehensive, coordinated care Medicare patients deserve.

Why Choose PromiseCare for Your Medicare Care:

Ready to Get Started?

Contact PromiseCare Medical Group to:

PromiseCare Medical Group
41885 E Florida Ave
Hemet, CA 92544
Phone: (951) 390-2840
Website: promisecare.com

Medicare coordination doesn’t have to be overwhelming. With the right information, timely enrollment, annual reviews, and a healthcare partner like PromiseCare Medical Group, you can confidently manage your Medicare coverage throughout retirement while focusing on what matters most—your health and well-being.

Medical Disclaimer

Important Healthcare Information Notice

This article provides general educational information about Medicare coverage coordination and is not intended to replace professional medical, financial, or insurance advice. The information presented here is current as of January 2026 but is subject to change as Medicare policies, premiums, and regulations are updated by the Centers for Medicare & Medicaid Services (CMS).

Medical Advice Disclaimer:
The content in this article is for informational purposes only and should not be considered medical advice. Always consult with your qualified healthcare provider at PromiseCare Medical Group or another licensed physician regarding your specific health conditions, treatment options, and medical care decisions. Individual health circumstances vary, and what works for one person may not be appropriate for another.

Insurance and Financial Disclaimer:
Medicare coverage coordination involves complex rules that vary based on individual circumstances including employment status, other insurance coverage, health conditions, and geographic location. The information provided here is general guidance only. For personalized advice about your specific Medicare situation:

No Professional Relationship Created:
Reading this article does not establish a patient-physician relationship with PromiseCare Medical Group or create an advisor-client relationship for insurance or financial planning purposes. For personalized medical care, schedule an appointment with a PromiseCare provider. For insurance enrollment assistance, contact PromiseCare Member Services at (951) 390-2840.

Medicare Plan Information Accuracy:
While we strive to provide accurate information about Medicare Advantage plans, Part D prescription drug plans, and Medigap policies, specific plan details including premiums, benefits, copayments, deductibles, formularies, and network providers change annually. Always verify current plan information using the official Medicare Plan Finder at Medicare.gov or by contacting plans directly during enrollment periods.

Geographic Limitations:
PromiseCare Medical Group serves Riverside County, California. Medicare Advantage plan availability, network participation, and specific benefits vary by geographic service area. Information about PromiseCare’s network participation applies only to Riverside County and may not reflect availability or coverage in other regions.

Late Enrollment Penalty Calculations:
Late enrollment penalty calculations and examples provided are based on 2026 premium amounts. These amounts change annually, and your actual penalty may differ based on the year you enroll and current Medicare premium rates. Contact Social Security or Medicare directly for precise penalty calculations specific to your situation.

Not a Substitute for Official Medicare Resources:
This article supplements but does not replace official Medicare communications including:

Individual Circumstances Vary:
Medicare coordination situations vary significantly based on factors including:

Consult Healthcare Providers:
Always discuss your Medicare coverage options with your healthcare providers to ensure selected plans provide access to the doctors, specialists, hospitals, and services you need. Verify network participation before enrolling in any Medicare Advantage plan.

PromiseCare Availability:
While PromiseCare Medical Group participates in many Medicare Advantage plans, not all plans include PromiseCare in their network. Always verify PromiseCare’s participation in your specific Medicare Advantage plan before enrolling by contacting the plan or PromiseCare Member Services.

Regulatory Compliance:
PromiseCare Medical Group decision-making is based only on appropriateness of care and service and existence of coverage. PromiseCare does not specifically reward practitioners or other individuals conducting utilization review for issuing denials of coverage.

Note: PromiseCare Medical Group is a healthcare provider network. We are not affiliated with or endorsed by the U.S. government or the federal Medicare program.

For questions about your specific situation, consult appropriate qualified professionals including your physician, licensed insurance agent, and benefits administrator.

Last Updated: January 2026